Originally Posted by Vashtia
Some Drs start out at a ridiculously low dose ... not sure why ...
I'll try to shed some light on this. I apologize in advance if I come off as a know it all, but I think this is an important question, and people need to understand this.
There is another regular poster to this board that is extremely sensitive to stimulants. This poster has more or less quit stimulants, and when she does take Adderall, sticks to a dose of about 5mg. On the other hand, I tend to require in excess of what is usually considered the maximum therapeutic dose before I see positive effect. We have both found significant symptom relief from the same meds, but the doses we use to get that effect couldn't be more different.
When I first came to this board (~2008), the standard practice in the medical field for starting someone on a stimulant med was starting at the lowest possible dosage and stepping up over a matter of weeks until the dosage was high enough to work, or it was decided the medication was ineffective. In the intervening years this practice seems to have changed, judging by the number of people coming here complaining of severe side effects and euphoric highs followed by horrific crashes. Many doctors now seem to be throwing people in the deep end, so to speak, and this is leading to a lot of people having extremely negative experiences.
Finding the right med for treating your ADHD can be a very long and extremely frustrating experience. I myself spent two years trying a succession of options at different doses and combinations before I found what worked for me. The difference in my symptoms, however, since I found the right combo at the right dose can only be described as magical. Sadly, I have developed resistance to my meds over the last couple of years, and my effect has declined, an unfortunate feature of pharmaceutical ADHD treatment.
My psychiatrist started me on a new medication recently, and despite our previous experiences with my high level of tolerance, he started me at the lowest possible dose. While I know this means I won't see any effect right away, I took this as further confirmation that I have an excellent doctor. Starting low is the right way.
Spacedout45 - You're on the right track. It might take time, and might be frustrating, but keep the faith - it sounds like you have a smart doctor.